TY  - JOUR
U1  - Wissenschaftlicher Artikel
A1  - Linke, Christina
A1  - Ehlert, Karoline
A1  - Ahlmann, Martina
A1  - Fröhlich, Birgit
A1  - Mohring, Daniela
A1  - Burkhardt, Birgit
A1  - Rössig, Claudia
A1  - Groll, Andreas H.
T1  - Epidemiology, utilisation of healthcare resources and outcome of invasive fungal diseases following paediatric allogeneic haematopoietic stem cell transplantation
JF  - Mycoses
N2  - Summary

Background
Epidemiology and management practices of invasive fungal diseases (IFD) after allogeneic haematopoietic stem cell transplantation (HSCT) are a subject of constant change. We investigated the contemporary incidence, diagnostics, antifungal management and outcome at a major paediatric transplant centre in Germany.


Methods
The single‐centre retrospective observational study included all paediatric allogeneic HSCT patients (pts) transplanted between 2005 and 2015. Patient‐related data were assessed up to 365 days post‐transplant. The primary endpoint was the incidence of possible, probable and proven IFDs. Secondary endpoints included diagnostics and antifungal treatment; analysis of risk factors; and overall survival with the last follow‐up in January 2017.


Results
A total of 221 first (196), second (21) or third (4) procedures were performed in 200 pts (median age: 9 years, range, 0.5‐22) for leukaemia/lymphoma (149) and non‐malignant disorders (72). Prophylaxis was administered in 208 HSCT procedures (94%; fluconazole, 116, mould‐active agents, 92). At least one computed tomography scan of the chest was performed in 146, and at least one galactomannan antigen assay in 60 procedures. There were 15 cases of proven (candidemia, 4; aspergillosis, 4) or probable (aspergillosis, 7) IFDs, accounting for an incidence rate of 6.8%. Overall mortality at last follow‐up was 30%; the occurrence of proven/probable IFDs was associated with a reduced survival probability (P < .001).


Conclusion
Morbidity and mortality from IFDs at our institution were consistent with data reported from other centres. Utilisation of healthcare resources for prevention, diagnosis and management of IFDs was considerable.
KW  - -
KW  - children
KW  - diagnostics
KW  - management
KW  - mycoses
KW  - transplantation
Y1  - 2020
UN  - https://nbn-resolving.org/urn:nbn:de:gbv:9-opus-40596
SN  - 1439-0507
SS  - 1439-0507
U6  - https://doi.org/10.1111/myc.13029
DO  - https://doi.org/10.1111/myc.13029
VL  - 63
IS  - 2
SP  - 172
EP  - 180
PB  - Wiley
CY  - Hoboken, New Jersey
ER  -